Factors influencing adherence to standard precautions among nursing professionals in psychiatric hospitals

OBJECTIVE Evaluate and correlate individual, work-related and organizational factors that influence adherence to standard precautions among nursing professionals of psychiatric hospitals in São Paulo. METHOD An exploratory cross-sectional study conducted with 35 nursing professionals, using the assessment tool for adherence to standard precautions through the Likert scale, ranging from 1 to 5. RESULTS Knowledge of the precautions received a high score (4.69); adherence received (3.86) and obstacles (3.78), while intermediaries and the scales of organizational factors received low scores (2.61). There was a strong correlation between the magnitude adherence scale and the personal protective equipment availability (r = 0.643; p = 0.000). The training scale for prevention of HIV exposure (p = 0.007) was statistically different between the nurses and nursing assistants. CONCLUSION The organizational factors negatively contributed to adherence to standard precautions, indicating that psychiatric institutions lack safe working conditions, ongoing training and management actions to control infections.

Socio-economic inequalities in health in Catalonia

In this paper we measure the degree of income related inequality in mental health as measured by the GHQ instrument and general health as measured by the EQOL-5D instrument for the Catalan population. We find that income is the main contributor to inequality, although the share of inequality in mental health that can be explained by income is much greater than the corresponding share of inequality in general health. We also find that the variation in demographic structure reduces income related inequality in mental health but increases income related inequality in general health. The regional variations in both instruments for health are striking, with the Barcelona districts faring relatively bad with respect to the rest of geographical areas and Lleida being the health region where, all else held equal, the population reports the greatest level of health. A big share of inequality in the two health measures, but specially mental health, is due to the favourable position in both health and income of those who enjoy an indefinite contract with respect to the rest of individuals. We also find that risky working conditions affect both health measures and are able to explain an important share of socio-economic inequality.

Sarcomeric M-band alterations as a marker for human dilated cardiomyopathy

Purpose: The M-band is an important cytoskeletal structure in the centre of the sarcomere, believed to cross-link the thick filament lattice. Its main components are three closely related modular proteins from the myomesin gene family: Myomesin, M-protein and myomesin-3. Each muscle is characterized by its unique M-band protein composition, depending on the contractile parameters of a particular fiber. To investigate the role of the M-band in one of the most relevant and clinically increasing cardiac diseases, we analyzed the expression of myomesin proteins in dilated cardiomyopathy (DCM).Methods: In a previous study we analyzed mouse models suffering from DCM, demonstrating that the embryonic heart specific EH-myomesin splicing isoform was up-regulated directly corresponding to the degree of cardiac dysfunction and ventricular dilation. Based on this study, human ventricular and atrial samples (n=32) were obtained during heart surgery after informed consent and approval by an institutional review board. Patients were aged 30-70 years and suffered from dilated cardiomyopathy (DCM;n=13), Hypertrophic Cardiomyopathy (HCM;n=10) or served as controls (n=9). Patients suffering from DCM or HCM were in endstage heart-failure (NYHA III-IV) and either underwent heart transplantation or Left Ventricular Assist Device (LVAD) implantation. Heart samples from patients who underwent valve surgery or congenital heart surgery served as controls. Heart Samples were analyzed using RT-PCR, Western blot, and immunofluorescence.Results: By investigating the expression pattern of myomesins, we found that DCM is accompanied by specific M-band alterations, which were more pronounced in ventricular samples compared to the atrium. Changes in the amounts of different myomesins during DCM occurred in a cell-specific manner, leading to a higher heterogeneity of the cytoskeleton in cardiomyocytes through the myocardial wall with some cells switching completely to an embryonic phenotype.Conclusions: Here we present that the embryonic heart specific EH-myomesin isoform is up-regulated in human DCM. The alterations of the M-band protein composition might be part of a general adaptation of the sarcomeric cytoskeleton to unfavorable working conditions in the failing heart and may modify the mechanical properties of the cardiomyocytes. We suggest that the upregulation of EH-myomesin might play a pivotal role in DCM and might support classical imagingas a novel sarcomeric marker for this disease.

Sex differences in urinary levels of several biological indicators of exposure: a simulation study using a compartmental based toxicokinetic model

Toxicokinetic modeling is a useful tool to describe or predict the behavior of a chemical agent in the human or animal organism. A general model based on four compartments was developed in a previous study in order to quantify the effect of human variability on a wide range of biological exposure indicators. The aim of this study was to adapt this existing general toxicokinetic model to three organic solvents, which were methyl ethyl ketone, 1-methoxy-2-propanol and 1,1,1,-trichloroethane, and to take into account sex differences. We assessed in a previous human volunteer study the impact of sex on different biomarkers of exposure corresponding to the three organic solvents mentioned above. Results from that study suggested that not only physiological differences between men and women but also differences due to sex hormones levels could influence the toxicokinetics of the solvents. In fact the use of hormonal contraceptive had an effect on the urinary levels of several biomarkers, suggesting that exogenous sex hormones could influence CYP2E1 enzyme activity. These experimental data were used to calibrate the toxicokinetic models developed in this study. Our results showed that it was possible to use an existing general toxicokinetic model for other compounds. In fact, most of the simulation results showed good agreement with the experimental data obtained for the studied solvents, with a percentage of model predictions that lies within the 95% confidence interval varying from 44.4 to 90%. Results pointed out that for same exposure conditions, men and women can show important differences in urinary levels of biological indicators of exposure. Moreover, when running the models by simulating industrial working conditions, these differences could even be more pronounced. In conclusion, a general and simple toxicokinetic model, adapted for three well known organic solvents, allowed us to show that metabolic parameters can have an important impact on the urinary levels of the corresponding biomarkers. These observations give evidence of an interindividual variablity, an aspect that should have its place in the approaches for setting limits of occupational exposure.

Iron oxides and quality of organic matter in sugarcane harvesting systems

Improvements in working conditions, sustainable production, and competitiveness have led to substantial changes in sugarcane harvesting systems. Such changes have altered a number of soil properties, including iron oxides and organic matter, as well as some chemical properties, such as the maximum P adsorption capacity of the soil. The aim of this study was to characterize the relationship between iron oxides and the quality of organic matter in sugarcane harvesting systems. For that purpose, two 1 ha plots in mechanically and manually harvested fields were used to obtain soil samples from the 0.00-0.25 m soil layer at 126 different points. The mineralogical, chemical, and physical results were subjected to descriptive statistical analyses, such as the mean comparison test, as well as to multivariate statistical and principal component analyses. Multivariate tests allowed soil properties to be classified in two different groups according to the harvesting method: manual harvest with the burning of residual cane, and mechanical harvest without burning. The mechanical harvesting system was found to enhance pedoenvironmental conditions, leading to changes in the crystallinity of iron oxides, an increase in the humification of organic matter, and a relative decrease in phosphorus adsorption in this area compared to the manual harvesting system.

Dones a la ciència i a la universitat: la construcció de la identitat docent i investigadora en contextos de desigualtat

[cat] Aquest treball recull el procés i els resultats de la recerca "Dones a la Ciència i a la Universitat: la contribució de la identitat docent i investigadora en contextos de desigualtat" (2007 RDG 00001)finançada per l'Agència de Gestió d'Ajuts Universitaris i de Recerca (AGAUR) en la convocatòria d'ajuts per a l'estudi de desigualtats originades per motius de gènere en l'àmbit científic i universitari (RDG) per l'any 2007. La finalitat d'aquest projecte ha estat explorar i reconstruirl'experiència personal i professional de tres generacions de dones en el procés de construcció de la seva identitat com a docents, investigadores i gestores. La forma d'assolir aquesta finalitat ha estatl'elaboració de 8 històries de vida professional per tal de comprendre la relació entre les seves trajectòries i les condicions de la seva feina i esbrinar com es van convertir en la mena de donesprofessores, investigadores o gestores que ara són; així com les relacions entre les experiències personals i el desenvolupament de les seves trajectòries professionals. En aquest procés s'han posat en evidència les estratègies d'adaptació, resistència i creació que les dones desenvolupen enla seva interacció amb el context de la docència, la recerca i la gestió, les formes de violència simbòlica que experimenten, i els canvis que s'han produït al centres de recerca i les universitats catalanes des de la perspectiva de gènere en els darrers trenta anys.

Exposure to bioaerosols, respiratory health and lung-specific proteins: a prospective study in garbage and wastewater workers.

Objectives To prospectively assess respiratory health in wastewater workers and garbage collectors over 5 years. Methods Exposure, respiratory symptoms and conditions, spirometry and lung-specific proteins were assessed yearly in a cohort of 304 controls, 247 wastewater workers and 52 garbage collectors. Results were analysed with random coefficient models and linear regression taking into account several potential confounders. Results Symptoms, spirometry and lung-specific proteins were not affected by occupational exposure. Conclusions In this population no effects of occupational exposure to bioaerosols were found, probably because of good working conditions.

Dones a la ciència i a la universitat: la construcció de la identitat docent i investigadora en contextos de desigualtat

[cat] Aquest treball recull el procés i els resultats de la recerca "Dones a la Ciència i a la Universitat: la contribució de la identitat docent i investigadora en contextos de desigualtat" (2007 RDG 00001)finançada per l'Agència de Gestió d'Ajuts Universitaris i de Recerca (AGAUR) en la convocatòria d'ajuts per a l'estudi de desigualtats originades per motius de gènere en l'àmbit científic i universitari (RDG) per l'any 2007. La finalitat d'aquest projecte ha estat explorar i reconstruirl'experiència personal i professional de tres generacions de dones en el procés de construcció de la seva identitat com a docents, investigadores i gestores. La forma d'assolir aquesta finalitat ha estatl'elaboració de 8 històries de vida professional per tal de comprendre la relació entre les seves trajectòries i les condicions de la seva feina i esbrinar com es van convertir en la mena de donesprofessores, investigadores o gestores que ara són; així com les relacions entre les experiències personals i el desenvolupament de les seves trajectòries professionals. En aquest procés s'han posat en evidència les estratègies d'adaptació, resistència i creació que les dones desenvolupen enla seva interacció amb el context de la docència, la recerca i la gestió, les formes de violència simbòlica que experimenten, i els canvis que s'han produït al centres de recerca i les universitats catalanes des de la perspectiva de gènere en els darrers trenta anys.

Factors associated with healthcare professionals' intent to stay in hospital: a comparison across five occupational categories.

OBJECTIVE: To identify factors associated with intent to stay in hospital among five different categories of healthcare professionals using an adapted version of the conceptual model of intent to stay (CMIS). DESIGN: A cross-sectional survey targeting Lausanne University Hospital employees performed in the fall of 2011. Multigroup structural equation modeling was used to test the adapted CMIS model among professional groups. Measures Satisfaction, self-fulfillment, workload, working conditions, burnout, overall job satisfaction, institutional identification and intent to stay. PARTICIPANTS: Surveys of 3364 respondents: 494 physicians, 1228 nurses, 509 laboratory technicians, 935 administrative staff and 198 psycho-social workers. RESULTS: For all professional categories, self-fulfillment increased intent to stay (all β > 0.14, P < 0.05). Burnout decreased intent to stay by weakening job satisfaction (β < -0.23 and β > 0.22, P < 0.05). Some factors were associated with specific professional categories: workload was associated with nurses' intent to stay (β = -0.15), and physicians' institutional identification mitigated the effect of burnout on intent to stay (β = -0.15 and β = 0.19). CONCLUSION: Respondents' intent to stay in a position depended both on global and profession-specific factors. The identification of these factors may help in mapping interventions and retention plans at both a hospital level and professional groups' level.

Preserving the health of ambulance personnel : some preliminary results from a study of pre-hospital emergency interventions

Little is known about the health of ambulance personnel, especially in Switzerland. This lack of knowledge is particularly striking in the specific field of occupational health. This study aims to identify and better understand protective and risk factors affecting the health of ambulance personnel. Both mental and physical health are considered. The approach used comprised two steps. The first step began in July 2008 and consisted in a qualitative study of real work activities performed by ambulance crews involved in pre-hospital emergency interventions. Researchers shadowed ambulance personnel for the duration of their entire work shift, in average for one week. The paper-pen technique was used to note dialogues, interactions, postural aspects, etc. When the situation allowed it, interventions were filmed. Some selected video sequences were used as a support for selfconfrontation interviews. Observations were performed by three researchers and took place in eleven services, for a total of 416 hours of observations (including 72 interventions + waiting time). Analysis, conducted by a multidisciplinary team (an ergonomist, an occupational therapist and a health psychologist), focused on individual and collective strategies used by ambulance personnel to protect their health. The second step, which is currently ongoing, aims to assess global health of ambulance personnel. A questionnaire is used to gather information about musculoskeletal complaints (Nordic questionnaire), mental health (GHQ-12), stress (Effort-Reward imbalance questionnaire), strategies implemented to cope with stress (Brief COPE), and working conditions. Specific items on strategies were developed based on observational data. It will be sent to all ambulance personnel employed in the French-speaking part of Switzerland. Preliminary analyses show different types of strategies used by ambulance personnel to preserve their health. These strategies involve postural aspects (e.g. use doorframe as a support to ease delicate manipulations), work environment adaptations (e.g. move furniture to avoid awkward postures), coping strategies (e.g. humor), as well as organisational (e.g. formal and informal debriefing) and collective (e.g. cooperation) mechanisms. In-depth analysis is still ongoing. However, patient safety and comfort, work environment and available resources appear to influence the choice of strategies ambulance personnel use. As far as possible, the strategies identified will be transformed into educational materials for professional ambulance personnel.

LM-vesiturbiinin tuotteistaminen

Tämän työn tarkoituksena on kehittää LM-vesiturbiini tuotantoon soveltuvaksi, käytöltään pitkäikäiseksi ja helposti huollettavaksi tuotesarjaksi. Työn ohjaavana runkona on käytetty VDI-Richtlinie 2221: 'Kehitystyön ja konstruoinnin yleinen kulku', mukaista järjestelmää. Lisäksi on käytetty valmistuksellista modulointia tuotteen osien suunnittelussa. Erityisesti on huomioitu tuotteen koko elinkaaren aikaiset kustannukset (LCC) ja sen vaatimukset mitoitukseen. LM-vesiturbiinistaon kehitetty kolmen erikokoisen laitteiston tuotesarja. Tuoteperheen yksittäisistä sylinteriryhmistä voidaan koota joustavasti erikokoisia ja -tehoisia energiantuotantoyksiköitä, jotka soveltuvat käyttöön hyvin pieniinkin virtauksiin ja putouskorkeuksiin. Piensarjatuotantoon hyvin soveltuvat materiaalit on valittu silmälläpitäen mahdollisimman edullista kokonaiskustannusta. Kiertomäntä laitteiston toiminnan kannalta tärkeimpänä ja siten vaativimpana osana on edellyttänyt laserhitsausta ja -leikkausta sekä koekappaleiden valmistusta, joiden perusteellalopulliseen rakenteeseen on päädytty. Mitoitus perustuu perinteisiin lujuuslaskentamenetelmiin, joiden avulla eri osien kestävyys käyttöolosuhteissa on pyrittysaamaan luotettavaksi vähintään 20 vuoden kestoiälle ja väsymiskestävyyteen käytön aikaisissa vaihtelevissa olosuhteissa. Kiertomäntä on ns. kevytrakenne koostuen ohutlevykennorakenteesta ja täytteenä olevasta kompound-materiaalista.

The profile of general practitioners (GPs) who publish in selected family practice journals

Background: Providing support for research is one of the key issues in the ongoing attempts to improve Primary Care. However, when patient care takes up a significant part of a GP's time, conducting research is difficult. In this study we examine the working conditions and profile of GPs who publish in three leading medical journals and propose possible remedial policy actions. Findings: The authors of all articles published in 2006 and 2007 in three international Family Medicine journals - Annals of Family Medicine, Family Practice, and Journal of Family Practice - were contacted by E-mail. They were asked to complete a questionnaire investigating the following variables: availability of specific time for research, time devoted to research, number of patients attended, and university affiliation. Only GPs were included in the study. Three hundred and ten relevant articles published between 2006 and 2007 were identified and the authors contacted using a survey tool. 124 researchers responded to our questionnaire; 45% of respondents who were not GPs were excluded. On average GPs spent 2.52 days per week and 6.9 hours per day on patient care, seeing 45 patients per week. Seventy-five per cent of GPs had specific time assigned to research, on average 13 hours per week; 79% were affiliated to a university and 69% held teaching positions. Conclusions: Most GPs who publish original articles in leading journals have time specifically assigned to research as part of their normal working schedule. They see a relatively small number of patients. Improving the working conditions of family physicians who intend to investigate is likely to lead to better research results.

Yksittäistuotannon robotisointi konenäön avulla

Työn tavoitteena oli uuden konenäköpohjaisen hitsausrobottiaseman käyttöönotto ja järjestelmän kehittäminen siten, että voitiin mahdollistaa vähintään vaadittu 70 %:n kaariaikasuhde ohjelmien sisällä. Aseman käyttöönotolla pyrittiin tehostamaan hitsaustyötä ja helpottamaan tuotanto-paineita osavalmistuksen paneeli-linjalla. Hitsausasemalla parannetaan myös työntekijöiden työergonomiaa sekä koko työn imagoa. Kirjallisen osan tarkoituksena oli tutkia robotisoitua hitsausta ja sen tuomia etuja, verrata jo olemassa olevia ohjelmointimenetelmiä uuteen ohjelmointitapaan ja selvittää robottien tarkkuuksia. Kirjallisuusosan jälkimmäisessä osassa tutustuttiin konenäköön ja sen laitteistoihin sekä sovelluksiin. Kirjallisuus-tutkimuksessa selvisi, että uusi ohjelmointimenetelmä on selvä parannus kyseiseen sovellukseen. Käytännön osassa on esitelty konenäköpohjainen hitsausrobottiasema sen suunnittelusta, käyttöönottoon ja tuotantotesteihin asti. Käytännön osassa on lisäksi esitelty asema osana koko automatisointiprojektia. Lisäksi on kerrottu järjestelmän toiminnasta sekä makroista, joihin robotin toiminta perustuu. Lopuksi on tehty katsaus maailmalla olevista vastaavista järjestelmistä ja niiden teknologioista sekä verrattiin niitä tähän uuteen järjestelmään. Tavoitteena olleeseen 70% kaariaikasuhteeseen ohjelmien sisällä päästiin jo lyhyen koejakson aikana. Käyttöönotettu konenäköpohjainen hitsausrobottiasema on tiettävästi ensimmäinen hitsausasema maailmassa, jota ei tarvitse ohjelmoida etukäteen. Ohjelmointiin kuluva aika on minimaalinen, koska operaattori ohjelmoi robotin sen hitsatessa tuotetta. Kokeellinen osa osoitti, että käyttöönotettu konenäköpohjainen hitsausrobottiasema toimii, kuten se oli suunniteltukin. Käyttöönoton yhteydessä huomattiin monia kehitettäviä asioita, joilla järjestelmästä on mahdollista saada vieläkin tehokkaampi.

Kuljettajien työn turvallisuus ja sen kehittäminen energia-alan kuljetustoiminnoissa

Työ kuuluu osana työn ja työliikenteen turvallisuuden kehittämishankkeeseen tavarankuljetusalalla. Hankkeen tavoitteena on selvittää kuorma-autonkuljettajan työpaikkatapaturmatilanteet ja tapaturmavaarat muun tutkimuksen pohjaksi. Diplomityössä kiinnitetään huomio tutkimushanketta tarkemmin energia-alan kuljetusten turvallisuustekijöihin. Diplomityön ja koko työn ja työliikenteen turvallisuuden kehittämishankkeen lähtökohtana on kuljettajan työnkuvan ongelmallisuus ja laajeneminen. Kuljettajien työ on tiukasti aikataulutettua ja työolot usein varsin vaihtelevia. Kuljettajien työ on yksintyöskentelyä vierailla paikoilla ja usein yötyötä. Työmääräykset kuljettajille tulevat lyhyellä varoitusajalla. Kuljettajien työturvallisuutta selvitettiin kirjallisuustutkimuksella, kenttätyöllä, kyselytutkimuksella kuljetusyrityksille sekä tilastoja tarkastelemalla.